Vein stripping surgical instrument

ABSTRACT

The present invention relates to a surgical instrument for extracting or stripping of veins in connection with surgical treatment of varicose veins. The vein stripper comprises a string-shaped body which preferably has a uniform cross section along the whole length thereof except from a section of reduced width positioned at least at one and preferably at both end portions of said body and spaced from the adjacent free end thereof. The vein stripper also comprises an enlarged element or a stripper head having a longitudinally and radially extending slit or slot and preferably also a central non-through end bore or depression at least at one end surface and preferably at both end surfaces for receiving part of the string-shaped body in locking engagement. The opposite end surfaces of the stripper head may be shaped differently and may for example have a convex and a concave shape, respectively.

United States Patent 1 1 1111 3,788,325 Jacobsen Jan. 29, 1974 [5 VEINSTRIPPING SURGICAL INSTRUMENT 3,659,606 5/1972 Reimels .5 128/303 R [75]Inventor: 3:32 3 g g Primary Examiner-Aldrich F. Medbery Attorney,Agent, or Firm-Anthony P. Delio et al. [73] Assignee: Astra-Sjuco adivision under Astra-Gruppen A/S, Roskildevej, [57] ABSTRACT AlbertslundDenmark The present invention relates to a surgical instrument [22]Filed: Sept. 22, 1972 for extracting or stripping of veins in connectionwith surgical treatment of varicose veins. The vein stripper [21] Appl'291192 comprises a string-shaped body which preferably has a uniformcross section along the whole length thereof [30] Forei n Application Pi it D t except from a section of reduced width positioned at Sept. 221971 Denmark 4631/71 least at one and Preferably al boll end Polllollsof Said body and spaced from the adjacent free end thereof. 52 US. Cl128/303 R The vein Stripper comprises an enlarged element 51 1111.01A6lb 17/00 or a Stripper head having a longitudinally and radially 58Field of Search 128/303 R 304 341 extending Slit 0r Slot and Preferablyalso a central through end bore or depression at least at one end sur-[56] References Cited face and preferably at both end surfaces forreceiving part of the string-shaped body in locking engagement. UNITEDSTATES PATENTS The opposite end surfaces of the stripper head may be giu g shaped differently and may for example have a convex a en 13,185,155 5/1965 $131611 et al. 128/303 R and a concave shaperespectwely' 3,508,553 4/1970 Kanbar et a]. 128/303 R 12 Claims, 5Drawing Figures PATENTED JAN 2 9 I974 VEIN STRIPPING SURGICAL INSTRUMENTBACKGROUND OF THE INVENTION 1. Field of the Invention A so-called veinstripper is a surgical instrument for the extraction of veins inconnection with surgical treatment of varicose veins. The inventionrelates to such vein strippers.

2. Description of the Prior Art The most commonly used known veinstrippers are of the type comprising a string-shaped body having anenlarged end portion at each end, and a stripper head having anon-through axial end bore or recess at each end and a radial slit orslot extending axially from one end of the stripper head to the other.The string-shaped body is normally made from plastics material which ispreferably monoaxially oriented in the string-shaped portion betweensaid enlarged end portions. When a vein, for example vena saphena magna,is to be extracted by means of a stripper of the type described thesurgeon effects an entrance into the vein by making an incision in thepatients leg adjacent to the groin as well as adjacent to the ankle, andthereafter one end of the stripper is inserted into the vein. Themaximum diameter of the enlarged end portions of the stripper must be alittle smaller than the inner diameter of the vein, and therefore, thestring-shaped body between said end portions must necessarily berelatively thin, and it is also rather flexible. The high flexibility ofthe stringshaped portion is caused by the monoaxial orientation of theplastics material performed in order to obtain the tensile strengthnecessary for the rather thin stringshaped body. Due to the highflexibility of the stringshaped body a stripper of the type describedmust be inserted in the vein at the distal incision, i.e. in such adirection that the vein valves may be pushed open. When thestring-shaped body has been inserted in the vein section defined betweenthe two incisions made in the patients leg and thus extends through thevein section along the whole length thereof the stripper head is mountedon an end section of the string, said end section being received in theradial slit or slot of the stripper head. Thereafter the head is beinglocked in an aligned position by displacing the string and the head inrelation to each other in such a manner that the adjacent enlarged endportion is received in the recess or end bore defined in one end surfaceof the stripper head. The vein may now be extracted thereby that themounted stripper head is being drawn in one direction or the otherthrough the tubular passage in the leg defined by the tissue surroundingthe outer wall of the vein. I

When a vein stripper is inserted in vena saphena magna through thedistal incision in the patients leg and as described above this isnecessary when a stripper of the above known type is used there is riskthat the string-shaped body is forced into vena femoralis through apiercing and reaches the groin through the last mentioned vein.Therefore, it would be desirable to have a string-shaped body being sostiff that it could pierce the vein valves and thus be inserted into thevein from the proximal incision in the leg, if desired.

Another type of known vein strippers comprises a string-shaped bodywhich is sufficiently stiff to be able to pierce the vein valves.However, these vein strippers are provided with a stripper head which ispermanently fixed to the string-shaped body at one end thereof. A

stripper of the last-mentioned type may be inserted into the vein fromthe distal or the proximal incision as desired, but before inserting thevein stripper the surgeon must decide in which direction he desires toextract the vein, because due to the fact that the stripper head ispermanently fixed the direction of extracting the vein is necessarilythe same as the direction of inserting the string-shaped body therein.The choice of direction of extraction is not unimportant becauseextraction in a distal direction reduces the risk of injuring nervussaphenus, causes extraction of increased lengths of tributary veins ofvena saphena magna, and reduces the risk of invagination of vena saphenamagna. In return, the extraction in distal direction does not allowcompression bandages to be arranged on the leg concurrently with theextraction. By extracting the vein in proximal direction it is possibleto provide the leg with such a bandage, but in return the advantagesmentioned in connection with extraction in distal direction may not beobtained.

It is necessary to obtain security against that the stripper headpermanently fixed to the string-shaped body or the enlarged end portionson such body are not torn off during vein extraction, and therefore thesaid stripper head or enlarged end portions must either be formedintegrally with the string or be properly fastened thereto. In the knownvein strippers described above the integral forming of the enlarged endportions or stripper heads on the string-shaped body involvessubstantially increased manufacturing costs which is especiallydisadvantageous for vein strippers of the disposable type.

SUMMARY OF THE INVENTION body, a section of said end portion spaced fromthe adjacent free end of the string-shaped body having a re-l:

duced width and being adapted to be received in a substantially radialslit or slot defined in said enlarged element or head, the maximum outerdiameter of the central portion as well as of the free end portions ofthe string-shaped body exceeding the width of said slit or slot. It isunderstood that the enlarged element or stripper head of the surgicalinstrument or vein stripper according to the invention may be mounted onthe stringshaped body in a similar manner as described above inconnection with the first-mentioned known vein stripper, the free endportion of the string-shaped body adjacent to and at the outer side ofthe section of reduced width serving the same purpose as the enlargedend portion of the said known stripper. The string-shaped body of thevein stripper according to the invention may be made in a very simpleand economical manner, for example by extrusion of plastics material,and may have a thickness or outer diameter being little smaller than theinner diameter of a vein to be extracted, and therefore, thestring-shaped body may be made so stiff that it may be inserted in thevein either from the distal or the proximal incision in the leg of thepatient. The section of the string-shaped body having a reduced widthmay for example have a round or square cross section, but has preferablyan oblong cross section which may for example be formed by thermoplasticdeformation of the string-shaped body, by milling or by any other typeof machining.

Preferably, the string-shaped body is provided with a section of reducedwidth at both ends. In that case the surgeon may postpone the decisionas to the direction of extraction of the vein till the string-shapedbody has been inserted therein. Thus, the vein stripper according to thepresent invention is very advantageous in manufacture as well as in use.Due to the relatively low manufacturing costs the vein stripperaccording to the invention is suited for being disposed after a singleuse.

According to the present invention the enlarged element or stripper headmay comprise a central end bore or recess at one or both ends forreceiving part of the adjoining end portion of the string-shaped bodywhen the section of reduced width has been received in the radial slitor slot of the stripper head. Thereafter the head and the body may beaxially displaced in relation to each other, whereby the stripper headmay be locked to the string-shaped body against relative transversedisplacement. The enlarged element or stripper head may be shapedsymmetrically about a plane vertical to the longitudinal axis of thehead. In that case the longitudinal orientation of the head isunimportant when being mounted on the string-shaped body by the surgeon.However, some surgeons prefer to use a stripper head having a convexlyrounded active end surface and other prefer an active end surface of theconcavely shaped type having a relatively sharp edge. According to theinvention the end surfaces of the stripper head may be shapeddifferently. For example, one of the end surfaces may be convex and theother end surface may be concave. In that case, the surgeon may choosehis favoured shape by mounting the stripper head on the string-shapedbody with the corresponding longitudinal orientation.

The section or sections of the string-shaped body having a reduced widthmay preferably have a substantially rectangular cross section themaximum dimension of which is identical or substantially identical tothe outer diameter or thickness of the adjoining portions of thestring-shaped body. Thereby the weakening of the string-shaped bodycaused by the said sections is reduced to a minimum.

BRIEF DESCRIPTION OF THE DRAWING Embodiments of the surgical instrumentor vein stripper according to the invention will now be described morein detail with reference to the accompanying drawing, wherein FIG. 1shows a side view of a first embodiment of the vein stripper accordingto the invention,

FIG. 2 shows in enlarged scale an end portion of a vein stripper shownin FIG. 1 provided with a modified stripper head,

FIG. 3 shows the end portion shown in FIG. 2 rotated 9 about itslongitudinal axis,

FIG. 4 shows an end view of the stripper head according to FIGS. 2 and3, and

FIG. 5 shows a side view of another embodiment of the stripper head.

DESCRIPTION OF THE PREFERRED EMBODIMENTS The surgical instrument or veinstripper shown in FIG. 1 consists of a string-shaped body or a probe andan enlarged element or stripper head 11 detachably mounted thereon. Bothof these parts may advantageously be made from plastics material, suchas polycarbonate, for example that marketed under the tradmark MAKROLON.The probe 10 as well as the head 11 have a substantially circular crosssection and the string-shaped body 10 has a reduced section 12 at eachend portion. In the embodiment shown on the drawing these reducedsections have a substantially rectangular cross section the length ofwhich is equal to the outer diameter of the body 10. However, inprinciple the reduced sections may have any cross section, for example asquare, an elliptical, or a circular cross section, provided that in atleast one direction the largest diameter of the cross section is smallerthan the outer diameter of the string-shaped body 10. The reducedsections 12, which may for example be made by thermoplastic deformation,by milling or another type of machining, are spaced from the respectivefree ends of the body 10 and thus they define or separate body endportions 13. The string-shaped body 10 having a diameter which ispreferably little smaller than the inner diameter of a vein to beextracted, is preferably solid, but may be hollow, if desired.Furthermore, the body 10 may possibly be provided with intervalreinforcing means, for example in the form of threads or wires.

In the embodiment shown in FIGS. 2 5 the stripper head is provided witha central, non-through end bore 14 at each end. The diameter of thesebores is equal to or a little greater than the diameter of the endportions 13 of the string-shaped body. The stripper head is alsoprovided with a radially extending and axially throughgoing slit or slot15 the width of which is smaller than the outer diameter of the body 10but greater than or equal to the smallest transverse dimension or widthof the reduced sections 12 of the body 10. It will be understood thatthe stripper head 11 may easily be mounted on the body 10 thereby thatone of the reduced sections 12 is being inserted in the slot 15 of thestripper head 11 so that the adjoining end portion 13 is being alignedwith one of the end bores 14. The end portion 13 may now be inserted inthe end bore 14 by a relative axial displacement of the body 10 and thestripper head 11, whereby the stripper head is being locked againsttransverse displacement and centred on the body 10. It should beunderstood that any other type of centring and locking means forcentring and locking the stripper head in relation to the string-shapedbody may be used.

In the embodiment shown in FIGS. 2 4 the stripper head 11 is symmetricalabout a plane vertical to the longitudinal axis of the head which hasconcave end surfaces 16. Due to the symmetrical shape of the head thelongitudinal orientation of the stripper head 11 is unimportant when thehead is being mounted on the body 10.

In the embodiment shown in FIG. 5 the stripper head 1 1 comprises aconcave end surface 16 as well as a convex end surface 11. The surgeonmay then chose whether the active end surface pointing in the directionof extraction should be concave or convex.

It should be understood, that various modifications of the embodimentsdescribed above may be made without departing from the scope of thepresent invention as defined in the appended claims.

I claim:

1. A surgical instrument for vein extraction comprising a string-shapedbody and an enlarged element or head with a substantially longitudinallyextending radial slot connectable to an end portion of said stringshapedbody in substantially aligned relationship therewith and having amaximum outer diameter exceeding that of the string-shaped body, asection of said end portion, spaced from the adjacent free end of thestring-shaped body, having at least one section of said body a reducedwidth and being shaped to be received in said substantially radial slitor slot defined in said enlarged element or head, the maximum outerdiameter of the central portion, as well as of the free end portions, ofthe string-shaped body exceeding the width of said slit or slot.

2. A surgical instrument according to claim 1 and comprising a sectionof reduced width at each end portion of said string-shaped body.

3. A surgical instrument according to claim 2, wherein an end surface ofsaid enlarged element or head includes a central recess or end bore forreceiving part of the string-shaped body adjoining said section ofreduced width and positioned intermediate of that section and theadjacent free end of the string-shaped body.

4. A surgical instrument according to claim 3, wherein a central recessor end bore includes a nonplanar end surface on each end of saidenlarged element or head.

5. A surgical instrument according to claim 4, wherein said end surfacesare shaped differently.

6. A surgical instrument according to claim 5, wherein one of said endsurfaces is convex whereas the other end surface is concave.

7. A surgical instrument according to claim 3, wherein saidstring-shaped body is made from plastic material.

8. A surgical instrument for vein extraction comprising a string-shapedbody made from plastics material, and an enlarged element or head havinga maximum outer diameter exceeding that of the string-shaped body andbeing detachably connectable to any one of the two end portions of saidstring-shaped body in substantially aligned relationship therewith, asection of each of said end portions of said string-shaped body spacedfrom the adjacent free ends thereof having a reduced width and beingshaped to be received in a substantially radial slit or slot extendinglongitudinally in said enlarged element or head, the maximum outerdiameter of the string-shaped body exceeding the width of said slit orslot, and the string-shaped body having a uniform cross section betweenand outside of its two sections of reduced width.

9. A surgical instrument according to claim 8, wherein an end surface ofsaid enlarged element or head includes a central recess or end bore forreceiving that part of the string-shaped body adjoining said section ofreduced width and positioned intermediate of that section and theadjacent free end of the stringshaped body.

10. A surgical instrument according to claim 9, wherein a central recessor end bore includes a nonplanar end surface of said enlarged element orhead.

11. A surgical instrument according to claim 10, wherein said endsurfaces are shaped differently.

12. A surgical instrument according to claim 11, wherein one of said endsurfaces is convex, whereas the other end surface is concave.

PO-wso UNITED STATES PATENT OFFICE CERTIFICATE OF CORRECTION Patent No.3,788,325 med n ary 29, 197

Inventor) Bj arne Hamilton Jacobsen It is certified that error appearsin the above-identified patent and that said Letters Patent are herebycorrected as shown below:

Column 1, line 15, after "other" insert '--as exemplified in BritishPatent No. l,26 4,976--.' Column 3, line 29, "other" should read-others--'. Column 3, line 58, "9" ould read --9O- Column 4-, line 1 jte-r" should read -dimension. Column 4, line 25, -'interval" should read-i nternal--. Column 4, line 58, "chose" should read -+-choose--. Claim8, line 2, "plastics" should read -plastic-'-. Claim 10, line 3, insert--on each end-- after "surface". Column 5, line 5, after "body" delete-a-, and insert in place thereof --at least one-. Column 5, line 6, Cafter "portion" insert --of said body--. Column 5, line 7, after"having" delete -at least one section of 'said body--. Claim 7, line 1,"3" should read -2--.

I Signed and sealed this 20th day of August 1974.

(SEAL) Attest:

McCCY M. GIBSON, JR. C. MARSHALL CDANN Attesting Officer Commissioner ofPatents

1. A surgical instrument for vein extraction comprising a string-shapedbody and an enlarged element or head with a substantially longitudinallyextending radial slot connectable to an end portion of saidstring-shaped body in substantially aligned relationship therewith andhaving a maximum outer diameter exceeding that of the string-shapedbody, a section of said end portion, spaced from the adjacent free endof the string-shaped body, having at least one section of said body areduced width and being shaped to be received in said substantiallyradial slit or slot defined in said enlarged element or head, themaximum outer diameter of the central portion, as well as of the freeend portions, of the stringshaped body exceeding the width of said slitor slot.
 2. A surgical instrument according to claim 1 and comprising asection of reduced width at each end portion of said string-shaped body.3. A surgical instrument according to claim 2, wherein an end Surface ofsaid enlarged element or head includes a central recess or end bore forreceiving part of the string-shaped body adjoining said section ofreduced width and positioned intermediate of that section and theadjacent free end of the string-shaped body.
 4. A surgical instrumentaccording to claim 3, wherein a central recess or end bore includes anon-planar end surface on each end of said enlarged element or head. 5.A surgical instrument according to claim 4, wherein said end surfacesare shaped differently.
 6. A surgical instrument according to claim 5,wherein one of said end surfaces is convex whereas the other end surfaceis concave.
 7. A surgical instrument according to claim 3, wherein saidstring-shaped body is made from plastic material.
 8. A surgicalinstrument for vein extraction comprising a string-shaped body made fromplastics material, and an enlarged element or head having a maximumouter diameter exceeding that of the string-shaped body and beingdetachably connectable to any one of the two end portions of saidstring-shaped body in substantially aligned relationship therewith, asection of each of said end portions of said string-shaped body spacedfrom the adjacent free ends thereof having a reduced width and beingshaped to be received in a substantially radial slit or slot extendinglongitudinally in said enlarged element or head, the maximum outerdiameter of the string-shaped body exceeding the width of said slit orslot, and the string-shaped body having a uniform cross section betweenand outside of its two sections of reduced width.
 9. A surgicalinstrument according to claim 8, wherein an end surface of said enlargedelement or head includes a central recess or end bore for receiving thatpart of the string-shaped body adjoining said section of reduced widthand positioned intermediate of that section and the adjacent free end ofthe string-shaped body.
 10. A surgical instrument according to claim 9,wherein a central recess or end bore includes a non-planar end surfaceof said enlarged element or head.
 11. A surgical instrument according toclaim 10, wherein said end surfaces are shaped differently.
 12. Asurgical instrument according to claim 11, wherein one of said endsurfaces is convex, whereas the other end surface is concave.